IOM DHSC & MANX CARE

[cissolt]

Is £800,000 per year for the current board value for money? Or sustainable long term?

[Banker]

4 hours ago, cissolt said:

Is £800,000 per year for the current board value for money? Or sustainable long term?

Don’t know but Jersey seems to have done something similar & paying their chairman £225k pa + expenses for 3 days per week!!

https://www.bailiwickexpress.com/jsy/news/health-minister-encouraged-critical-report-author-apply-chair-role/#.Y44czOSnyEc

[360 View]

3 hours ago, Banker said:

Don’t know but Jersey seems to have done something similar & paying their chairman £225k pa + expenses for 3 days per week!!

https://www.bailiwickexpress.com/jsy/news/health-minister-encouraged-critical-report-author-apply-chair-role/#.Y44czOSnyEc

£225k - Plus accommodation and travel expenses  - how much has been paid in expenses to the Manx Care Exec Board and exactly which people get paid by Cabinet Office and which by Manx Care?

[littlebushy]

23 hours ago, wrighty said:

You’re referring to Dirk Hoehmann I assume. In this case I don’t think phonecalls would have helped much. He worked in Aintree before here, I believe, and was clinically soind, so off-radar phonecalls wouldn’t have raised any alarm bells. I think CRB checks were done, but didn’t cover his European time, so didn’t pick up the wanted criminal bit. 
 

Re my previous post. I should point out that the serving chips/finance director story relates to a UK hospital, not Noble’s. 

We knew that Wrighty, if it was local they would have been serving chips, cheese and gravy.

[Apple]

On 12/4/2022 at 8:18 PM, 360 View said:

Perhaps I should think about setting up a service to do the checks for Manx Care…. 

I can see a time when that function will be farmed out to the private sector. I would agree with it.

Checks and CVs for DHSC staff were, and I believe even now for Manx Care staff, are under the remit of the centralised Human Resources Department, now the Office of Human Resources (OHR), That body has a Director on the Manx Care Board.

[Viddy well]

On 12/4/2022 at 8:04 PM, wrighty said:

Not that I want to start a turf war, but this is one of the causes of the ‘them and us’ situation that undoubtedly exists between hospital management and clinicians. 
 

When you appoint a nurse/doctor (to a substantive, permanent position) there are people on the panel specifically to ensure that the candidates are qualified for the role, such that you can be pretty sure when a consultant is appointed, he or she will be fully qualified, be on the specialist register, has undertaken higher specialist training etc. When a senior manager is appointed there are no such checks, because there are no such qualifications and no regulatory bodies to check with. This leads to stories, for example, of finance directors who used to serve the chips in the canteen.  And since medical careers are often far longer lasting, there can be current consultants who were in post when said finance director used to serve the chips. You can see why there might not be the mutual respect that there ought to be. 
 

I think the NHS are trying to address this through the leadership academy etc, but we still see managers appointed who have no qualifications besides their self-authored LinkedIn profile. 

Hi Wrighty,

in your opinion, how long will it realistically take for the "them and us" culture to change, assuming the management do everything right? How deeply sown are the divisions? How wrecked is the institution and how ardent are its rescuers?

Edited December 6, 2022 by Viddy well

[Anyone]

Surely the availability of good quality chips in any NHS facility outweighs who serves them. I think brain surgeons should serve them and perhaps trick cyclists fry them. All managed by the BMA and whoops because the BMA gets involved no one gets chips except a few select ( BMA ) doctors. And all the rest of us expecting chips just get a recording saying ‘ your call can’t be connected today try again tomorrow if you’re still alive’. 

[CallMeCurious]

A&E struggling again, long waiting lists and ever rising costs. Dr A.A. is introducing an assisted dying bill aka state sanctioned euthenasia. 

https://laws-lois.justice.gc.ca/eng/acts/C-46/page-34.html#docCont

That is an example of legisaltion from Canada. They are currently running at 3.3% average (and as high as 4.7-4.8% in two provinces) euthanised death to all causes#. And it's increasing year on year since introduced in 2016.

2020 IOM all causes 917 registered deaths* so 3% rate would equate to about 27 a year (and as high as 44 @ 4.8% rate).  

(#source - Third annual report on Medical Assistance in Dying in Canada 2021 ~Chart 3.2

https://www.canada.ca/en/health-canada/services/medical-assistance-dying/annual-report-2021.html#chart_3.2

(*source ~ IOMG Mortality Report 2020 published June 2020.)

https://www.gov.im/media/1376766/mortality-report-2020-v2.pdf

Lets hope we never see a headline like this;

Paralympian claims Canada offered to euthanise her when she asked for a stairlift

‘I have a letter saying that if you’re so desperate, madam, we can offer you... medical assistance in dying,’ Christine Gauthier told a Canadian veterans affairs committee

[Thorulf]

1 hour ago, CallMeCurious said:

A&E struggling again, long waiting lists and ever rising costs. Dr A.A. is introducing an assisted dying bill aka state sanctioned euthenasia. 

https://laws-lois.justice.gc.ca/eng/acts/C-46/page-34.html#docCont

That is an example of legisaltion from Canada. They are currently running at 3.3% average (and as high as 4.7-4.8% in two provinces) euthanised death to all causes#. And it's increasing year on year since introduced in 2016.

2020 IOM all causes 917 registered deaths* so 3% rate would equate to about 27 a year (and as high as 44 @ 4.8% rate).  

(#source - Third annual report on Medical Assistance in Dying in Canada 2021 ~Chart 3.2

https://www.canada.ca/en/health-canada/services/medical-assistance-dying/annual-report-2021.html#chart_3.2

(*source ~ IOMG Mortality Report 2020 published June 2020.)

https://www.gov.im/media/1376766/mortality-report-2020-v2.pdf

Lets hope we never see a headline like this;

Paralympian claims Canada offered to euthanise her when she asked for a stairlift

‘I have a letter saying that if you’re so desperate, madam, we can offer you... medical assistance in dying,’ Christine Gauthier told a Canadian veterans affairs committee

Its a pity we don't see head lines that read.

 90yo man with dementia and arthritis of the spine gets violent by knocking over glass had to be restrained with Midazolam & Benzodiazepines to be kept under control. Ultimately ended up starving to death with a touch of pneumonia all alone due to lockdown measures.

The Human race needs to work out assisted dying and we need to keep religion out of the debate.

[Apple]

3 hours ago, Thorulf said:

The Human race needs to work out assisted dying and we need to keep religion out of the debate.

That is the second reference to religion in this debate. 

I am not religious. However I can see patients themselves and families who are would very much be wanting their voices to be heard. And why not. Are there an other voices you want to exclude before the debates start ? Courts maybe ? 

No, of course everyone should have their say.

Assisted dying has been practiced before but never in the transparent way that is required to day, primarily thanks to characters like Dr Shipman. It has, hopefully, been practiced judiciously and with integrity by those involved and people have been allowed to slip away to prevent distress in one form or another. Happened in my own family several years ago.

I think people forget it shouldn't and will not be compulsory and it is far removed from the often quoted "assisted suicide" misconception. It has also to be considered in tandem with Capacity and excellent End of Life Care services. 

 

[WTF]

1 hour ago, Apple said:

That is the second reference to religion in this debate. 

I am not religious. However I can see patients themselves and families who are would very much be wanting their voices to be heard. And why not. Are there an other voices you want to exclude before the debates start ? Courts maybe ? 

No, of course everyone should have their say.

 

 

allowing imaginary friends to influence anything other than being sectioned should not be permitted in an enlightened society.

[Thorulf]

5 hours ago, Apple said:

That is the second reference to religion in this debate. 

I am not religious. However I can see patients themselves and families who are would very much be wanting their voices to be heard. And why not. Are there an other voices you want to exclude before the debates start ? Courts maybe ? 

No, of course everyone should have their say.

Assisted dying has been practiced before but never in the transparent way that is required to day, primarily thanks to characters like Dr Shipman. It has, hopefully, been practiced judiciously and with integrity by those involved and people have been allowed to slip away to prevent distress in one form or another. Happened in my own family several years ago.

I think people forget it shouldn't and will not be compulsory and it is far removed from the often quoted "assisted suicide" misconception. It has also to be considered in tandem with Capacity and excellent End of Life Care services. 

 

Sorry I didn't mean to offend by bringing religion into it, it's just  seems to be one of the obstacles. He had wonderful people looking after him it's just happened around all the Covid bo*#&%ks and  didn't have a very good end, I could write an essay about it but I won't....don't start me on politicians partying grrrr

[Apple]

Hi @Thorulfno need to apologise and certainly no offence taken. 

The picture you describe is heart breaking and should not be allowed. It sadly is not unique. I have heard similar and worse occasions where people have been 'left to waste away' devoid of any dignity, compassion  and company. 

More is needed to bring these events to the attention of those who develop strategy, policies and make the decisions and make them accept the responsibility and accountability for the failures that create and lead to them.

Sadly as you refer to it there are too many ways now for those who do make decisions to avoid any charges of theory own lack of actions and failure, use the national media to only put their own cases forward, shut down patients and families real life experiences and their complaints, lack transparency despite their election policies and manipulate the 'messages' to cause dismay, anxiety and confusion whilst making their names and their comfortable life styles on the shoulders of the vulnerable.

Political debate of circumstances that patients and families are suffering are not not discussed but I am willing to bet that every MHK is aware of problems within our health and care services that their constituents are experiencing. What is the point of that I ask, and so should we all.

I welcome Dr Allinson's Bill and the debates and issues  that it will bring forward. What I really fear is how it will be interpreted and work in actual practice. We must have close monitoring to ensure ethical and moral behaviour are there at every stage. I don't think any other politician we have will understand the commitments that this Bill will require to ensure it does what it says on the tin.

[2112]

Have things got that bad and hit rock bottom? The NPM reports that the MEDS service between midnight and 8am is closing until further notice, due to sickness and staff shortage. We have a hospital A&E that can’t cope at all, and Manx Care signposting people to Ramsey Cottage Hospital Minor Injuries Unit, which is fine, if you can get there, and the weather is fine. Can things get any worse?

[Zulu]

21 minutes ago, 2112 said:

Have things got that bad and hit rock bottom? The NPM reports that the MEDS service between midnight and 8am is closing until further notice, due to sickness and staff shortage. We have a hospital A&E that can’t cope at all, and Manx Care signposting people to Ramsey Cottage Hospital Minor Injuries Unit, which is fine, if you can get there, and the weather is fine. Can things get any worse?

Manx Care

 

The Manx Emergency Doctors Service (MEDS) will be closing between midnight and 08:00 until further notice.

The decision to close the service between these hours has not been taken lightly, and is due to sickness within the MEDS team. There will be an answerphone message signposting callers, and the MEDS management team continues to work with other services to ensure safe continuity of patient care.

MEDS was also forced to close at short notice last night (11-12 December 2022) for the same reason, but it should be noted that any calls received last night would have been diverted to the hospital Switchboard. Contacts to the service during the night have been assessed, and these did not directly impact other services.

Going forward, during these times, if you believe that the reason you are calling MEDS cannot wait until when your GP opens in the morning, please make your way to the Emergency Department.

If you think that you have a life-threatening emergency, you should always call 999. This service operates 24 hours a day, 7 days a week.

Please consider whether you can get the help you need elsewhere – our signposting information can be found here: https://www.gov.im/cate.../health-and-wellbeing/signposting/

Members of the public are also asked to consider the weather conditions (a Yellow Weather Warning is currently in place), and to follow Isle of Man Government advice regarding travel at this time: https://www.facebook.com/iomgovernment